Search

ObjectiveTo report the demographics and the clinical course of patients with multiple evanescent white dot syndrome (MEWDS) and to investigate for those factors which influence visual acuity (VA) recovery.MethodsThis is a retrospective single-centre observational study. Electronic medical records and retinal imaging of patients with a diagnosis of MEWDS with a minimum follow-up of 3 months were reviewed. Patients were categorised into three groups according to the VA at presentation and at the last visit: group 1 >0.48 logarithm of the minimum angle of resolution (LogMAR), group 2 ≤0.48 and ≥0.18 LogMAR and group 3 ResultsA total of 51 eyes from 51 patients (41 women, mean age 29.8±7.8 years) were included. Significantly more patients presented in the autumn (X2=8.69, p=0.034). The percentage of eyes recovering vision to 0.0 LogMAR or better was 80.3% (41/51). Worse presenting vision and young age at presentation were independent significant predictive variables for poorer final VA (p=0.002 and p=0.02, respectively). No imaging features were significantly predictive of complete versus incomplete recovery, but disc hyperfluorescence on fluorescein angiography was more common in those with incomplete recovery.ConclusionsAlthough the majority of cases have a benign prognosis, the clinical spectrum of MEWDS includes incomplete visual recovery. In our series, poor presenting VA and young age were associated with poor VA outcome. Further study is warranted to confirm these findings.

This work concerns the subjective impression of perceived illumination. The purpose of the study is to test attributes expressing qualitative experiences referring to ambient lighting that can be applied as descriptors. Seventy participants viewed an actual model room, with the fourth wall removed (viewing booth). Walls, floor, and ceiling were achromatic. Two achromatic cubes were placed inside the room: One was a reflectance increment to the walls, the other a decrement. The room was illuminated by two different light sources, Artificial Daylight (D65) or Tungsten Filament (F), the order of which was randomized across participants. The participants’ task was to evaluate ambient illumination for each light source. A semantic differential method was employed with 27 pairs of adjectives on 1 to 7 rating scales, categorized in three groups: characteristics of atmosphere, time, and cross-modal. Only the ratings of nine pairs of adjectives were not influenced by the type of illumination. The most differentiated couples under different illuminants were hot/cold and modern/old, but large differences also appeared with the following couples: hard/soft, technological/primitive, summery/wintry, warm/cool, sensual/frigid, natural/artificial, and hospitable/inhospitable. The hypothesis that there would be consistency among the subjects in evaluations of the characteristics tested and that these would be differently perceived under different illuminants was confirmed. The results show that it is possible to identify subjective perceived illumination as a phenomenon endowed with specific filling-in qualities and that as a perceptual experience it can be categorized, with implications for application in architecture and design.

Recent findings have shown that sounds improve visual detection in low vision individuals when the audiovisual stimuli pairs of stimuli are presented simultaneously and from the same spatial position. The present study purports to investigate the temporal aspects of the audiovisual enhancement effect previously reported. Low vision participants were asked to detect the presence of a visual stimulus (yes/no task) presented either alone or together with an auditory stimulus at different stimulus onset asynchronies (SOAs). In the first experiment, the sound was presented either simultaneously or before the visual stimulus (i.e., SOAs 0, 100, 250, 400 ms). The results show that the presence of a task-irrelevant auditory stimulus produced a significant visual detection enhancement in all the conditions. In the second experiment, the sound was either synchronized with, or randomly preceded/lagged behind the visual stimulus (i.e., SOAs 0, ± 250, ± 400 ms). The visual detection enhancement was reduced in magnitude and limited only to the synchronous condition and to the condition in which the sound stimulus was presented 250 ms before the visual stimulus. Taken together, the evidence of the present study seems to suggest that audiovisual interaction in low vision individuals is highly modulated by top-down mechanisms.

The study analyzes the existence of naturally biased associations in the general population between a series of musical selections and a series of quatrains. Differently from other studies in the field, the association is tested between complex stimuli involving literary texts, which increases the load of the semantic factors. The stimuli were eight quatrains taken from the same poem and eight musical clips taken from a classical musical version of the poem. The experiment was conducted in two phases. First, the participants were asked to rate 10 couples of opposite adjectives on a continuous bipolar scale when reading a quatrain or when listening to a musical clip; then they were asked to associate a given clip directly with the quatrains in decreasing order. The results showed the existence of significant associations between the semantics of the quatrains and the musical selections. They also confirmed the correspondences experienced by the composer when writing the musical version of the poem. Connotative dimensions such as rough or smooth, distressing or serene, turbid or clear, and gloomy or bright, characterizing both the semantic and the auditory stimuli, may have played a role in the associations. The results also shed light on the accomplishment of the two diverse methodologies adopted in the two different phases of the test. Finally, the role of specific musical components and their combinations is likely to have played an important role in the associations, an aspect that shall be addressed in further studies.

In our research, we tested for the existence of cross-modal visual and tactile associations in the experience of abstract art. Specifically, we measured the association of 60 abstract paintings with four couples of antonyms related to texture, such as warm or cold, smooth or rough, lightweight or heavy, soft or hard, investigating if the different modality of presentation on a computer screen (color versions: natural colors, inverted colors, black and white) gave rise to different associations relative to the four couples of opponent qualities. Second, we tested whether there might be differences between the ratings of the paintings when they were presented as images on a computer screen versus in real life at the museum. The results confirmed that associations between visual and tactile experience with such complex stimuli exist. In the case of the couple warm or cold, a significant inversion of associated qualities occurs when the images are presented in inverted colors as opposed to natural colors; furthermore, when presented in black and white, warm evaluations are “cooled down,” but cold evaluations remain the same. The degree of smoothness could be considered not associated with the color versions. When seen in black and white, both the mean softness and the mean lightweight-ness of the paintings were reduced; however, in the last case, this effect was more evident for the most lightweight pictures. There is only a slight difference between the two presentations of the paintings as images presented on a computer screen and seen in real life, relative to the warm or cold and soft or hard dimensions. Of the four opponent qualities, the three pairs warm or cold, lightweight or heavy, and soft or hard showed the most interesting results in relation to the cross-modal associations.

BACKGROUND Erythrocyte mean corpuscular volume (MCV) has been used for decades as a biomarker of chronic alcohol abuse and in the treatment of alcohol dependence. More recently, it has also been adopted to investigate the fitness of subjects to hold the driving license to prevent traffic accidents. So far, however, the studies on the association of MCV with an increased risk of alcohol-associated car accidents are extremely scarce, if not totally absent. To the best of our knowledge, the present work is the first specifically aimed at studying a plausible association between elevated MCV and crash accidents correlated with alcohol abuse. METHODS A total of 6,244 drivers involved in traffic accidents underwent mandatory laboratory analyses including blood alcohol concentration (BAC) determination and MCV analysis. BAC and MCV determinations were performed by headspace gas chromatography and complete blood count, respectively. RESULTS The chi-square test evaluating the proportions of subjects with elevated MCVs (>95 fl) yielded a highly significant result (χ2 = 68.0; p 0.5 g/l). However, when considering only drivers showing BACs in the range of 0.51 to 1.5 g/l, the frequencies of elevated MCV values are fairly comparable (χ2 = 0.062, p = 0.80). In contrast, limiting the evaluation to BACs > 1.5 g/l, the frequency of elevated MCVs raised to 19.1% (χ2 = 58.9, p value

This article presents an experimental study on the naturally biased association between shape and color. For each basic geometric shape studied, participants were asked to indicate the color perceived as most closely related to it, choosing from the Natural Color System Hue Circle. Results show that the choices of color for each shape were not random, that is, participants systematically established an association between shapes and colors when explicitly asked to choose the color that, in their view, without any presupposition, they saw as the most naturally related to a series of given shapes. The strongest relations were found between the triangle and yellows, and the circle and square with reds. By contrast, the parallelogram was connected particularly infrequently with yellows and the pyramid with reds. Correspondence analysis suggested that two main aspects determine these relationships, namely the "warmth" and degree of "natural lightness" of hues.

Objective Evidence is limited regarding outcome of patients with ectopic Cushing’s syndrome (ECS) due to neuroendocrine tumors (NETs). Design We assessed the prognostic factors affecting the survival of patients with NETs and ECS. Methods Retrospective analysis of clinicopathological features, severity of hormonal syndrome, treatments from a large cohort of patients with NETs and ECS collected from 17 Italian centers. Results Our series included 110 patients, 58.2% female, with mean (±s.d.) age at diagnosis of 49.5 ± 15.9 years. The main sources of ectopic ACTH were bronchial carcinoids (BC) (40.9%), occult tumors (22.7%) and pancreatic (p)NETs (15.5%). Curative surgery was performed in 56.7% (70.2% of BC, 11% of pNETs). Overall survival was significantly higher in BC compared with pNETs and occult tumors (P = 0.033) and in G1-NETs compared with G2 and G3 (P = 0.007). Negative predictive factors for survival were severity of hypercortisolism (P P = 0.001), diabetes mellitus (P = 0.0146) and distant metastases (P P Conclusions Multiple factors affect prognosis of ECS patients: type of NET, grading, distant metastases, severity of hypercortisolism, hypokalemia and diabetes mellitus. BCs have the highest curative surgical rate and better survival compared with occult tumors and pNETs. Hypercortisolism plays a primary role in affecting outcome and quality of life; therefore, prompt and vigorous treatment of hormonal excess by NET surgery and medical therapy should be a key therapeutic goal. In refractory cases, adrenalectomy should be considered as it affects outcome positively at least in the first 2 years.

The study shows a systematic naturally biased association between percepts and concepts. Specifically, it shows that a series of terms pertaining to an abstract semantic field (related to the frame of ethics in social behaviour) has a nonrandom, highly significant, association with colours (hues). This is the first time that consistent associations between abstract terms and colours have been reported in the general population. The main hypothesis, ie that there appear to be ‘hues of concepts’, was borne out by the results: The abstract terms considered were coloured with blue/green (ie cool) colours as well as their synonyms, while their antonyms were coloured with red/yellow (ie warm) colours. The association provides information about the nature of abstract concepts and their relationship with perception. It also sheds light on the interrelations among words in semantic domains that, to date, have been studied from only a computational viewpoint.

Aims and background The presence of nodal metastases in patients with primary cutaneous melanoma adversely affects the biological behavior and is related to a poor prognosis. The role of sentinel lymph node biopsy is still debated. The aim of this study was to evaluate the prognostic role of sentinel lymph node biopsy with respect to disease-free period and overall survival. Patients and methods Patients with invasive cutaneous melanoma who underwent sentinel lymph node biopsy in the Santa Chiara Hospital of Trento between October 1997 and December 2002 were evaluated. The lymph nodes were examined with conventional histology, S100 and tyrosinase in immunohistochemistry, and tyrosinase in molecular biology. Results There were 144 patients with 198 sentinel lymph nodes. A significant association was found in conventional histology with Clark level and Breslow thickness. The prognostic role of sentinel lymph node status was independent of the other considered variables. However, no significant association was found with the molecular biology test. A significant excess of positive results at molecular biology was found. Conclusions Sentinel lymph node biopsy is an important independent prognostic factor for invasive cutaneous melanoma, but only when evaluated with conventional histology. As a result of this study, we stopped performing the tyrosinase test in molecular biology.

Background: The province of Trento has been the target of health campaigns for early diagnosis of cutaneous melanoma for 30 years. Objective: To evaluate incidence and mortality data of skin melanoma in the province from January 1992 to December 2001. Methods: The study is based on the provincial skin cancer registry and the regional mortality registry. Standardized incidence and mortality rates were computed, and time trends were evaluated. Incidence rates were modeled using Poisson regression. Results: Five hundred fifty-four melanomas were diagnosed (226 in males and 328 in females). No period effect was revealed. Incidence rates in females were about 1.24 times those in males. No significant trend in mortality rates was observed. Conclusion: We examined incidence and mortality data of cutaneous melanoma during a 10-year period and failed to find any significant trend. It seems we have reached a plateau after many years of continuous, intensive health campaigns.

This study analyses how certain qualitative perceptual appearances of biological forms are correlated with expressions of natural language. Making use of the Osgood semantic differential, we presented the subjects with 32 drawings of biological forms and a list of 10 pairs of connotative adjectives to be put in correlations with them merely by subjective judgments. The principal components analysis made it possible to group the semantics of forms according to two distinct axes of variability: Harmony and dynamicity. Specifically, the nonspiculed, nonholed, and flat forms were perceived as harmonic and static; the rounded ones were harmonic and dynamic. The elongated forms were somewhat disharmonious and somewhat static. The results suggest the existence in the general population of a correspondence between perceptual and semantic processes, and of a nonsymbolic relation between visual forms and their adjectival expressions in natural language.

For this retrospective study, we divided 3814 patients with invasive operable breast cancer into five groups based on their age at diagnosis. Univariate analysis showed that the elderly women had larger tumours with more axillary node involvement and lymphovascular invasion, more estrogen- and progesterone-positive tumours, lower grades and proliferative indices, and were less likely to be c-erbB2 positive. They were more likely to have been diagnosed in a symptomatic state and to have undergone mastectomy, and less likely to have undergone mammary reconstruction or axillary dissection, or to have a family history of breast cancer. The multinomial regression model showed that pT, pN, ER, PgR, the type of diagnosis, and a family history were independently associated with each other. The results of this study show that elderly women are more likely to have larger and more frequently N+ tumours, but these are biologically less aggressive and usually seem to receive less invasive surgical treatment.

The aim of the study was to assess the activity and tolerability of the combination of gemcitabine (GEM) and vindesine (VDS) in elderly or poor performance patients with advanced non-small cell lung cancer. Forty four patients (36 males and 8 females with a median age of 70 years and a median Karnofsky performance score of 60) were recruited between January 1998 and June 2001; 9 (20.5%) were stage IIIB patients and 35 (79.5%) were stage IV patients; 20 (45.5%) had squamous carcinoma and 24 (54.5%) non-squamous carcinoma. The patients received GEM 1000 mg/m(2) and VDS 3mg/m(2) (max 5mg) on days 1 and 8 every 3 weeks, and were all evaluable for response and toxicity: 17 (38.6%) were partial responders, 17 (38.6%) experienced stable disease, and 10 (22.3%) progressive disease. Grade 3-4 anemia, neutropenia and thrombocytopenia were observed in, respectively, 6.8, 9.1 and 2.3% of the patients, and grade 2-3 fatigue, paresthesias and skin toxicity in, respectively, 11.4, 20.4 and 2.3%. After a median follow-up of 54 months, 43/44 patients died; median survival was 12 months, and a clinical benefit was observed in 54.5% of cases. GEM plus VDS is an active and well-tolerated schedule.

Laminin is a basement membrane glycoprotein implicated in a large number of biologic activities of cancer progression, many of which are mediated by the presence of the laminin receptor (67LR) on the cell membrane. We studied the correlations of laminin and its receptor with standardized and new prognostic factors (including bone marrow micrometastases) in a series of 112 patients with operable breast cancers. Laminin-positive cells were detected in 60% of the tumors and 67LR-positive cells in 55%; both were present in 35% of the cases. No association was found between laminin or 67LR positivity and pathologic tumor size, pathologic nodal status, grading, Ki-67, estrogen receptor status, progesterone receptor status, or bone marrow micrometastases. The only statistically significant association was with menopausal status and age, with a higher percentage of 67LR-positive tumors among premenopausal and younger patients. The median follow-up was approximately 7 years. The prognosis of disease-free survival was similar in the laminin-positive and laminin-negative subjects but was significantly better in 67LR-negative patients; there were no significant differences in overall survival. The prognostic role of laminin and 67LR in disease-free survival and overall survival varied according to nodal status. In the absence of nodal involvement, the risk of relapse (and death) was greater in the patients who were positive for laminin, 67LR, or both than in those who were negative for laminin, 67LR, or both; in the case of 4 or more involved nodes, the prognostic role of laminin and 67LR was reversed. These results did not change after adjustment for age, menopausal status, tumor status, nodal status, grading, or bone marrow micrometastases.

Background: A Skin Cancer Registry was established in the province of Trento in northeast Italy in 1992 with the aim of collecting data on all cutaneous tumors affecting residents. These neoplasms are responsible for considerable morbidity and utilization of the Health Service because of their high frequency and, therefore, knowledge of the exact incidence is very important in planning health policies. Registry data are also very helpful in performing studies of analytical and descriptive epidemiology. Methods: For each patient, we collected personal data, phenotypical characteristics, professional history, concurrent diseases, previous therapy or trauma, and all data regarding the tumors. Patients were interviewed in person or, less frequently, by phone. All data were verified and put in a computerized file, in a protected room. The Statistics Institute of Trento University analyzed the data. Comparison among means was performed using the analysis of variance and differences among proportions were tested by chi-squared analysis. Poisson regression and the likelihood ratio test were used to compare incidence rates. We analyze here the data regarding epiteliomas and melanoma. Results: During the study period we registered 3435 primary skin tumors in 2868 individuals. Crude incidence rates, calculated using the number of subjects (not the number of tumors), were 87.9 for basal cell carcinoma (BCC), 28.9 for squamous cell carcinoma (SCC), and 14.2 for cutaneous melanoma (CM), per 100,000 per annum. We also calculated the same figures in females and males and specific incidence rates in both sexes and evaluated the distribution of skin cancer according to sex and anatomical site. Conclusion: We report the analysis of the data collected by the Skin Cancer registry in a 6 year period and compare the data with published data in literature and with data of a previously registered melanoma file. Our results confirm the high incidence of non-melanoma skin cancers and the variation in the histological patterns of CM.

Background It is well known that mammographic screening reduces breast cancer mortality. One possible explanation for this effect is that screening makes it possible to detect smaller breast cancers with fewer involved nodes, but another hypothesis is that some screening-detected tumors are in a pathologically and biologically different phase of evolution from those that are detected clinically. The aim of the present study was to compare the biological, pathological and clinical characteristics of symptomatic vs. asymptomatic breast cancers. Patients and methods: The study considers a series of 1916 consecutive patients who underwent surgery for stage I and II infiltrating breast cancer at Verona hospitals after having undergone ultrasound and mammography (at least one of which was positive). They were divided into two groups on the basis of why they decided to undergo the imaging examinations: group A refers to the 1247 patients with a palpable lump, and group B to the 616 who were asymptomatic. Results The patients in group A were older, and had larger tumors and a higher percentage of positive nodes than those in group B; they also had significantly higher grade tumors, higher Ki-67 levels, and a higher percentage of ER and PgR negative and c-erbB-2 positive tumors (all of the P-values were significant). A logistic regression analysis adjusted for tumor diameter and age showed a reduction in the significance of each of the considered variables, but all of them remained significantly associated with the modality of diagnosis except ER, PgR and c-erbB-2. Conclusions Our results suggest that asymptomatic tumors are biologically different from their clinically presenting counterparts, thus confirming the hypothesis that progression towards greater malignancy may occur during the natural history of breast cancer.

The scheduled appointment system, widely used in most mental health services, has never been evaluated. This study attempts such an evaluation within a community-based mental health service that permits unplanned access to specialist care, by comparing further service use of first-episode patients who come unannounced to seek psychiatric care with that of patients with a planned (scheduled) initial appointment. All patients with first lifetime psychiatric contact who contacted psychiatric services reporting to the South-Verona Psychiatric Case Register between 1 January 1982 and 31 December 1989 (n = 1261) were identified. A total of 1056 patients entered the study and were followed for 2 years. Poisson regression with the generalised estimating equation (GEE) method (to take into account both overdispersion of contacts between subjects and correlation between contacts within subjects) was used to evaluate the effects of the type of first-ever contact (defined as planned or unplanned according to whether or not a regular appointment was previously arranged) and of other selected variables, including sociodemographic characteristics, on the annual rate of planned and unplanned care in the follow-up period. Thirty-six percent of first-ever contacts were unplanned. Patients who began with unplanned contact, as compared with others, were more often widowed, separated or divorced, unemployed and with a diagnosis of schizophrenia or organic psychosis. Moreover, they had, in the following 2 years, significantly higher rates of both unplanned and planned community care, as well as more in-patient care (higher admission rate and a longer mean length of stay). These results at follow-up were confirmed when the rates for the type of first-ever contact were adjusted for all other clinical and sociodemographic variables at initial contact. Step-down Poisson multiple regression analysis showed that the rates of both unplanned and planned contacts in the follow-up period were significantly and independently associated with: type of first-ever contact, diagnosis and type of service first contacted. Unplanned cases at initial contact require particular attention and are confirmed as at risk for placing higher demands on mental health services in the following 2 years. The results of the present study may also have implications for other, non-psychiatric health services.

ARMELLINI FABIO, MAURO ZAMBONI, TAMARA HARRIS, ROCCO MICCIOLO, OTTAVIO BOSELLO. Sagittal diameter minus subcutaneous thickness. An easy-to-obtain parameter that improves visceral fat prediction. Two groups of 99 and 98 women were studied to test if correcting sagittal diameter by subtracting the thickness of subcutaneous abdominal adipose tissue improves its degree of association with visceral adipose tissue. The first group (age, 40 ± 14 years; body mass index [BMI], 36 ± 6 kg/m2) was used to calculate the predictive equations for visceral adipose tissue. The second group (age, 43 ± 14 years; BMI, 37 ± 6 kg/m2) was used for cross-validation. Various anthropometric parameters were measured by ultrasound and computed tomography. Correlation coefficients with single-slice visceral adipose tissue area, after sagittal diameter was corrected by subtracting subcutaneous thickness, rose from 0.63 to 0.72 in the first group and from 0.64 to 0.71 in the second group. The standard error of residuals of the regression formula for visceral adipose tissue area was 10% lower with modified sagittal diameter than with sagittal diameter alone. During cross-validation, the standard error of differences was 5% lower with modified sagittal diameter. The visceral adipose tissue estimate was also less biased by the size of the area when sagittal diameter minus subcutaneous thickness was used. Results show that subtracting the thickness of abdominal subcutaneous adipose tissue from sagittal diameter significantly improves the predictive power of sagittal diameter for visceral adipose tissue and could be a useful tool for epidemiological studies.

The influence of the moon on patient consultations for anxiety or depression in general practice was assessed through a retrospective survey based on general practice medical records and on lunar records detailing the dates and times of different phases of the moon. Seven-hundred-eighty-two patients continuously registered in a general practice in Beckenham, South London, between 1971 and 1988 were included in analyses. No statistically significant lunar effect was found by setting the expected surge in consultations one to three days after the full moon and the period of the sine-wave curve to 30 days. Similarly, no statistically significant lunar effect was found, when the period of the sine-wave curve was allowed to vary in order to best fit the data. The moon had little influence on when individuals consulted their general practitioner with anxiety or depression.

SynopsisThe question addressed to in this paper is whether severely mentally ill patients are treated differently in a community mental health service without the back-up of a mental hospital (South-Verona, Italy) compared with an institution-based system in which mental hospitals, although highly modernized, are still predominant (Groningen, The Netherlands). Using the psychiatric case-registers in both areas, the patterns of care in 2 years of follow-up of schizophrenic patients were constructed. Survival analysis was used to analyse in-, day- and out-patient episodes of care. Three-quarters of the Groningen and half of the South-Verona patients experienced at least one episode of hospitalization; 20% of the Groningen and 5% of the South-Verona patients were long-stay patients at the end of the observation period. The South-Verona patients had more episodes of in-patient and especially of day-patient and out-patient care. Cox's regression showed that the duration of episodes controlled for the history of events and sociodemographic characteristics, was significantly shorter in South-Verona. One of the main conclusion was that hospitalizations for the severely mental ill are also needed in a community-based system of care, supporting the assumption of a ‘bed-rock’ of mental illness. However, the South-Verona community mental health service seems to be able to reduce the duration of hospitalizations considerably.

A comparison of 692 early invasive breast cancer with, and 1564 without, a family history of breast cancer showed that the former were younger at diagnosis (P=0.002), had smaller tumours (P=0.012), were more frequently oestrogen receptor positive (P=0.006) and diagnosed preclinically (P

To evaluate the association of obesity with comorbidity and with subjective health perception in a large sample representative of the Italian population and how the association differs by age and gender.Cross-sectional data were obtained from nine waves of the "Multipurpose Household Survey," conducted by the Italian National Institute of Statistics. Self-reported height and weight, six weight-associated diseases and self-rated health (SRH) were evaluated on 352,020 subjects aged 20 to 89 years. Comorbidity was defined as the presence of two or more diseases.The prevalence of comorbidity was significantly different between obese and normal weight subjects in all age categories. SRH was worse in obese subjects than in those of normal weight; this difference persisted, at least in females, into older ages.Obesity is associated with comorbidity and self-rated health; this association varies across ages and genders. The results found for obese subjects of a given age category were similar to (or worse than) those found for older normal weight subjects of the next age class. For comorbidity, this was true both in males and in females of all the considered age categories; for SRH, this was true in particular for females and younger males.

This study analyzed qualitative aspects in perception, particularly the relationship between morphological aspects of biological shapes and colour. The experiment reported by the study assessed the functional relation between shape and colour and, in particular, the relations among the patterns of shapes appearing in perceptual configurations, as well as certain characteristics of colour. Participants were shown 32 natural images and were asked to match them with a colour. The results indicated that some figures were more frequently associated (positively or negatively) with some colours instead of others. Type of shape, texture, and three-dimensionality were important elements in the participants' choices. Rounded figures and non-holed figures had positive matches with red; elongated figures were associated with colours between blue and green; and holed figures showed positive matches with colours between green and yellow. Type of shape and texture also exhibited a relationship with the warmth of the colour.

Relationships between obesity and fat distribution as evaluated by computed tomography and metabolic variables were studied in 35 men. Significant correlations emerged between body mass index and sum of glucose during oral glucose load and HDL3 triglycerides and also between visceral abdominal fat and triglycerides, apolipoprotein B, sum of insulin during oral glucose load, very-low-density-lipoprotein (VLDL) cholesterol, and VLDL and low-density-lipoprotein (LDL) triglycerides. Visceral abdominal fat correlated negatively with the ratio of HDL to LDL cholesterol. When the subjects were subdivided into four groups according to body mass index (or = 26.7,26.7) and median visceral abdominal fat, no significant differences were found in body mass index, whereas significant differences were found for triglycerides, cholesterol, apolipoprotein B, VLDL cholesterol, HDL:LDL cholesterol, and VLDL triglycerides. Our study shows that the amount of visceral abdominal fat is the most relevant factor for metabolic abnormalities. Our data also suggest that the effect of visceral fat is independent of body mass index.

We report the results of an investigation conducted in 992 healthy control subjects (854 adults and 138 adolescents) and in 116 subjects with lung cancer (LC) for the purpose of detecting those individuals with a possible genetic predisposition to lung cancer. The test consists of the oral administration of 64 mumol of dextromethorphan (DMP) with collection of urine samples over the following 8-h period and urine assay of the drug (DMP) and its main metabolite, dextrorphan (DOP). The ratio of the urinary concentrations of DMP to those of DOP is called the metabolic ratio (DMP/DOP) and is inversely proportional to the DMP demethylation rate. The pattern of the metabolic ratio (Log10 DMP/DOP) allowed, using a maximum likelihood approach, the identification of three subpopulations in the 854 control subjects (adults): (1) probable homozygous extensive metabolizers with Log10 DMP/DOP-1.74 (73.1 percent); (2) probable heterozygous intermediate metabolizers with Log10 DMP/DOP in the -1.74 to -0.40 range (22.3 percent); and (3) probable homozygous poor metabolizers with Log10 DMP/DOP-0.4 (4.6 percent). Most of the patients with LC (89 percent) were probable homozygous extensive metabolizers. As the latter have a cancer risk that is 2.54-fold greater than that of intermediate metabolizers (95 percent confidence interval [CI]: 1.37 to 4.73) and 7.43-fold greater than that of poor metabolizers (95 percent CI: 1.01 to 54.5), their identification by means of the DMP test may be particularly useful for subjects exposed to environmental and occupational carcinogens. The phenotype test used is similar to that of the debrisoquin test, but presents the advantage that DMP is a widely used, harmless drug with a faster and simpler urinary assay procedure.

BACKGROUND: Previous research has addressed the issue that low-level blood lead concentration could be associated with an increased risk of hypertension. METHODS: This paper examines the cross-sectional association between blood lead and hypertension in 630 adult males not employed in activities characterized by specific exposure to lead and living in two Northern Italian cities (Verona and Brescia). The participants, aged 26-69 years, constituted a random sample of the patients in the practice of a general practitioner (Verona) and of regular blood donors (Brescia). Logistic regression analysis was used to evaluate the effects of selected variables (blood lead, blood cadmium, zinc erythroprotoporphyrin, haemoglobin, whole blood viscosity, age, body mass index, smoking habits and alcohol consumption) on the probability of being hypertensive. RESULTS: The blood lead concentration (range: 4.3-46.9 micrograms/dl; median: 14.8 micrograms/dl) was very similar in the two samples, whereas the prevalence of hypertension was significantly higher in the Verona sample than in the Brescia sample (20.4% versus 8.3%). Hypertensive subjects showed significantly higher blood lead levels than normotensive ones. In a preliminary (univariate) analysis blood lead levels, body mass index (BMI) and age were each significantly related to the prevalence of hypertension. After adjusting for age and/or BMI, statistical significance of the relationship between blood lead and hypertension was lost.CONCLUSIONS. The present study showed that blood lead is weakly related to hypertension in non-occupationally exposed men. The statistical significance of this association disappeared when age and BMI were used to make adjustments.

Purpose To provide national, population-based estimates of the prevalence of overweight and obesity in the Italian population. Methods Prevalence estimates of overweight and obesity were calculated in seven waves (2001–2008) of the cross-sectional Multipurpose Household Survey organized by the Italian National Institute of Statistics, which are representative of the general adult Italian population. Sampling weights were used to estimate prevalence figures as well as their standard errors. Mean-difference plot was used to evaluate changes in the distribution of body mass index across sex and age categories. Results Almost half of Italian men and about 1 of 3 Italian women are overweight or obese. Between 2001 and 2008 the age-standardized prevalence of overweight (obesity) increased 1.4% (1.9%) in men and 0.4% (0.5%) in women. Mean-difference plots showed an upward shift for body mass index distribution with an increasing skewness. Conclusions The obesity epidemic is one of the major issues in United States and other developed countries. However, if for “epidemic” we mean that in Italy obesity is steadily increasing, then our data give little support to this interpretation. In fact, trends observed between 1983 and 2008 suggest that the rates of changes in the prevalence of overweight and/or obesity are not increasing.

Objective: In the latest years, mental hospitals have gradually been replaced by a community-based network of facilities, including non-hospital residential facilities (RFs). Little information is still available about their costs. Our aims were to estimate the costs of Italian RFs and to evaluate which factors affect the cost of RFs and their patients. Method: A representative sample of 265 Italian RFs, hosting 2962 patients, was selected for the study. RFs costs and costs of psychiatric, medical and informal care were estimated. Results: Patients in RFs cost between 7851 and 34 650 US$ per year; to this amount, it should be added from 2032 to 4702 US$ per year for the community psychiatric services (CPS). Significant differences were found by facility type, geographical areas, number of beds and age and diagnosis. About 45% of the variability for RF costs and 19% for CPS costs was explained by the regression models. Conclusion: The results can be useful to inform service planning and resource allocation.

BACKGROUND In healthy elderly, a reduction from the appetite and food intake of younger years has been defined as the "anorexia of aging," which may cause malnutrition. Leptin and ghrelin may alter the control of hunger and satiety and thus lead to anorexia. OBJECTIVE The aim of this study was to investigate how aging affects serum leptin and ghrelin concentrations in response to a meal and the relation of those hormones to hunger and satiety sensations. DESIGN We studied 8 community-dwelling elderly (x +/- SD age: 78 +/- 1 y) subjects and 8 younger (29.5 +/- 1 y) control subjects. Under fasting conditions and for 4 h after an 800-kcal mixed meal, satiety and hunger were evaluated at intervals, by using a visual analogic scale. Blood samples for leptin, ghrelin, and insulin measurements were collected at the following times: 30 min before and immediately and 30, 60, 120, and 240 min after the meal. RESULTS Postprandial satiety lasted significantly longer in the elderly than in the control subjects, and hunger was suppressed in the elderly throughout the observation. Fasting leptin was higher in the elderly than in the young (x +/- SE: 4.3 +/- 1.9 and 1.3 +/- 0.4 ng/mL, respectively; P < 0.05), and postprandial fluctuation was not significant. Fasting insulin also was significantly higher in the elderly than in the young (6.8 +/- 1.3 and 3.5 +/- 0.6 mU/L, respectively; P < 0.05), and the postprandial insulin rise was greater in the elderly. Fasting and postprandial ghrelin values did not differ significantly between the 2 groups. Insulin was inversely correlated with hunger and directly correlated with satiety scores. CONCLUSIONS In healthy elderly, anorexigenic signals prevail over orexigenic signals, and they contribute to prolonged satiety and inhibition of hunger. This condition may lead to a calorie deficit and finally to malnutrition in the elderly.

Objective: This paper reports the prescriptions of psychotropic drugs made to 2962 patients living in 265 residential facilities (RFs) in Italy. Method: Structured interviews were administered to RF managers and staff to obtain data on patients’ sociodemographic and clinical characteristics; information about current drug prescriptions were obtained from clinical records. Results: Polypharmacy was common: on average, each treated patient was taking 2.7 drugs (±1.1). The association of one atypical antipsychotic with one benzodiazepine represented the most common prescription profile. The variable most consistently associated with a higher likelihood of receiving polypharmacy was a history of admission to an acute general hospital psychiatric ward in the previous 12 months. Many prescriptions were loosely related to specific diagnoses. Conclusion: Psychotropic drug prescription patterns for severe patients living in RFs are characterized by substantial rates of polypharmacy. Specific guidelines may be helpful for long-stay patients living in RFs, who exhibit complex care needs.

SUMMARYAims— To investigate in a representative national sample (N=2,962) of patients living in Residential Facilities (RFs) patterns of polypharmacy as well as related variables, association between diagnoses and therapeutic patterns, and the rate of adverse events.Methods— Structured interviews focusing on each patient were conducted by trained research assistants with the manager and staff of each RF. Patients were rated with the HoNOS and the SOFAS, and comprehensive information about their sociodemographic and clinical status, and their pharmacological regimes were collected.Results— Conventional antipsychotics and second-generation antipsychotics were prescribed to 65% and 43% of the sample, respectively. Benzodiazepines were prescribed to two-thirds of the sample, while antidepressants were the least-used class of psychotropics. Polypharmacy was common: on average, each treated patient was taking 2.7 drugs (±1.1); antipsychotic polypharmacy was also common. Many prescriptions were loosely related to specific diagnoses. Antiparkinsonianian drugs were prescribed to approximately 1/4 of the sample. Mild or severe adverse events in the previous month were reported for 9.9% and 1.4% of the sample, respectively. About 15% of patients suffered from tardive dyskinesia.Conclusions— Psychotropic drug prescription patterns for severe patients living in RFs are only sometimes satisfactory and offer the opportunity of improvement. Specific actions are required to improve prescription patterns for severe patients in RFs.Declaration of Interest: in the past two years GdG has received two speaker fees from Janssen-Cilag and from Eli Lilly; GS has received one speaker fee from Solvay. RM, AP, SF and RT have received no fees or other financial support from pharmaceutical companies.

Objective. In Italy, Residential Facilities (RFs) have completely replaced Mental Hospitals (MHs) for the residential care of mentally ill patients. We studied all patients resident in 265 randomly sampled Italian RFs (20% of the total).Method. Structured interviews focusing on each patient were conducted by trained research assistants with the manager and staff of each RF. Patients were rated with the HoNOS and the GAF, and comprehensive information about their sociodemographic and clinical status and care history were gathered.Results. Of the 2962 patients living in the sampled facilities, most were males (63·2%) who had never married, more than 70% were over 40 years; 85% on a pension, most commonly because of psychiatric disability. A substantial proportion (39·8%) had never worked and very few were currently employed (2·5%); 45% of the sample was totally inactive, not even assisting with domestic activities in the facility. Two-thirds had a diagnosis of schizophrenia; co-morbid or primary substance abuse were uncommon. Twenty-one per cent had a history of severe interpersonal violence, but violent episodes in the RFs were infrequent. The managers judged almost three-quarters appropriately placed in their facilities and considered that very few had short-term prospects of discharge.Conclusions. Italian RFs cater for a large patient population of severely mentally ill requiring residential care. Discharge to independent accommodation is uncommon. Future studies should attempt to clarify how to match residential programmes with patients' disabilities.

Many inpatient treatments have been proposed for anorexia nervosa (AN) in the past, but few weight outcomes are available today. The criteria for outcome evaluation have always considered body weight. The fifty-three women with AN [26 restrictive (ANR) and 27 bulimic (ANB), studied in this paper were all those discharged in 1996 after an inpatient psycho-nutritional rehabilitation programme. Body weight and BMI were significantly increased between admission and discharge and this increase was maintained at the one-year follow-up. Mean weight in ANR and ANB were similar both at admission and on discharge, but showed significant differences at the follow-up. Follow-up weight was stable (+/- 5%) in 31%, decreased in 15% and increased in 54% of ANR, compared with 44%, 33% and 23% respectively in ANB. There were no differences in age and illness duration. It is very difficult to study presence or absence of menses because many patients were on estro-progestins. Furthermore, only 28% of patients with menses presented BMI higher than 17.5. Only the ANR group showed a significant weight increase at the follow-up. Their BMI was acceptable in 65% compared with 33% in the ANB group. Bulimic behaviour seems to be itself a negative prognostic factor for weight recovery.

Resting metabolic rate (RMR) and body composition were evaluated in 12 healthy volunteers before and after 16 days of high altitude trekking and climbing. RMR was measured by indirect calorimetry and body composition by electrical impedance. A 29% reduction in energy intake during high altitude exposure was observed. Fat mass loss averaged about 2.2 kg (p < 0.05) and lean body mass about 1.1 kg, which was almost significant (p = 0.07). As expected, estimated RMR at the end of the expedition--calculated by predictive formulae including body fat and lean body mass as covariates--was significantly reduced by 119 kcal/day as a consequence of the reduction in body weight. Measured RMR values, on the contrary, did not show any significant decline. In conclusion our study showed that high altitude trekking induced a weight loss due approximately 2/3rds to fat mass and 1/3rd to lean body mass. Decreased energy efficiency, which was still present several days after returning to sea level, may have helped contribute to weight loss due to reduced energy intake.

BackgroundPsychiatric case registers (PCRs) are particularly useful for studying patterns of care over time. Methods of ‘survival analysis’ have rarely been used for assessing such data.MethodA longitudinal study was conducted over 10 years (1 January 1982 to 31 December 1991) on 1423 first-ever psychiatric patients, using the PCR of South Verona, Italy. The product-limit method, the log-rank test, the Cox regression model and the Poisson regression analysis were used to analyse episodes of care and relapses.ResultsThe duration of the episodes of care increased consistently from the first to the fifth episode. The probability of opening a new episode of care after the first one increased consistently from the second to the sixth episode. The only variable significantly associated with the length of the first episode of care was diagnosis (highest probability of having longer episodes for schizophrenic patients), while the length of the breaks following the first episode of care was associated with diagnosis, sex and occupational status (highest probability of opening a second episode of care for schizophrenic subjects and those with alcohol and personality disorders, for males, and for unemployed patients). The probability of opening a new episode of care decreased with time since last contact and increased with number of previous contacts.ConclusionsThe community psychiatric service in South Verona is fulfilling its original aim, that is, to give priority to the continuity of care for patients with chronic and severe mental illnesses. Survival analyses proved to be useful methods for assessing episodes of care.

The association between obesity and perinatal, constitutional and social factors was studied in 1363 children (676 males, 687 females) living in six areas of north-east Italy. The children were randomly selected from four age categories (4,8,10 and 12 years of age). After adjustment for age, significant associations between the risk of obesity in the child and their body weight at birth (P0.01) and the father's or mother's body mass index (P0.001) were found in both genders. When these parental and perinatal variables were included as independent variables in a multiple logistic regression model controlling for the effect of age, parental body mass index and children's birth-weight remained independently associated with childhood obesity. In females, an interaction between birthweight and the mother's body mass index on the prevalence of obesity in childhood was found. In conclusion, parental obesity and birthweight represent major risk factors for obesity among children in north-east Italy.

Hemorrheologic parameters were significantly related to waist/hip ratio in men after controlling for body mass index, age, smoking, glucose, lipids, and blood pressure, whereas in women, lack of association was observed even after separately analyzing pre- and postmenopausal women.

In order to evaluate whether hypertension can be considered as a confounding factor in the setting up of reference values for blood lead, we examined the results of a cross sectional study which evaluated the relationship between lead in blood and hypertension in a sample of 254 males and 271 females of a general population not occupationally exposed to lead. The statistical analysis and in particular the multiple logistic regression showed that, even if some well-known confounding factors such as age, sex, overweight, smoking and alcohol are taken into account, blood lead levels are well correlated with hypertension. The results suggest that even modest lead absorption is able to influence the probability of being hypertensive. The relationship between blood lead and hypertension and their relationship with the main confounding factors involved in the determination of reference values of metals in blood are discussed.

The importance of body fat location as a predictor of metabolic aberrations was evaluated in 214 males and 244 females [aged 21–60] randomly selected from the patients of one general practice of Castel D'Azzano (Italy). The metabolic pattern, indexed by blood pressure, blood glucose, uric acid, serum triglycerides, HDL- and LDL-cholesterol was summarized in a haemodynamic-metabolic score (HMS). Association of HMS with age, anthropometric variables (skinfold thicknesses, girth lengths) and degree of overweight (body mass index, BMI) was evaluated in males and females using multiple regression analysis. Body fat location was associated with metabolic status independent of age in both sexes. This association was also independent of the degree of overweight. BMI, in general, was associated with HMS to a greater extent than anthropometric variables, except for waist girth; when its effect was taken into account BMI did not significantly improve the prediction power of HMS values in males. Among skinfolds, epimesogastric showed in both sexes the highest association with HMS. These results support the abdominal adiposity hypothesis and suggest that waist circumference could be a good index for assessing metabolic status. The abdominal location of adipose tissue, more than just the degree of overweight, could play a role in obesity related disorders.

The perceived stressfulness of 63 life events was compared in a North Italian and a South Italian sample, using a 0–20 equal interval scale. Each sample comprised 48 psychiatric patients and 34 relatives. Three-way analyses of variance for each event showed that South Italians consistently rated events as more upsetting, while patient or relative status and item order of the life event list did not affect the ratings. Multiple regression analysis showed that sociodemographic variables were not related to overall mean scaling scores with the exception of marital status which revealed a significant interaction with the city of residence. Southern Italians scaled recent events as more upsetting than events which had not occurred. This was not the case for the North Italian sample.

Seventy-six obese female outpatients underwent controlled 1000 kcal diets (50% carbohydrate, 25% fat, 25% protein). Prior-to-treatment data underwent "step-wise" multiple regression analysis to investigate the possibility of predicting body weight after 6 months of treatment (y), Body weight can be forecast using a linear regression function. This function, based on initial weight (x1) and adipose cell weight (x2), uses the equation y = 9.75 + 0.87x1 - 8.41x2 (F = 696.53; P less than 0.001; R2 = 0.95). Afterwards, patients were subdivided into three groups according to the difference between 6th and 12th month body weights: weight loss, weight stable, and weight increase groups. Weight gaining patients showed a significantly higher mean fat cell number, weight lossers had a higher mean adipose cell weight than the other two groups.

In South-Verona, where a community-based system of care consonant with the provisions of the Italian psychiatric reform has been operating since 1978, case-register data show that Long-stay inpatient rates are decreasing, while rates of patients treated long-term outside the mental hospital (i.e. those in "continuous care for one year, receiving treatment in the community by the various out-patient and day-patient facilities and in some cases short spells of inpatient care") show a recent increasing trend. Long-stay inpatients on 31.12 1982 have been compared with long-term community patients on the same date. The two cohorts were similar in terms of basic sociodemographic variables and contained a similar proportion of psychotic patients. However, while 88% of the long-stay inpatients were still long-stay after two years, only 45% of the long-term patients in the community remained in long-term treatment over the same period. Using a log-linear model, diagnosis was found to be the variable with the highest association in the long-term cohort with subsequent pattern of use of mental health services.

Thirty-eight patients (13 men and 25 women) with impaired glucose tolerance, aged 33–70 yr, underwent a dietary program adding 20 g of raw bran to their usual diet without changing their dietary habits. After 1 mo of treatment, the areas under the curves for glucose and insulin were reduced from 26,214 ± 5618 to 24,529 ± 5207 g/min (P < 0.001) and from 15,893 ± 9714 to 12,440 ± 7377 mU/min (P < 0.001), respectively, cholesterol was reduced from 234 ± 40 to 212 ± 29 mg/dl (P < 0.001), and triglycerides were reduced from 108 ± 56 to 97 ± 50 mg/dl (P < 0.05). Body weight (initially 128.44% relative body weight) decrease 0.8% (P < 0.02). After the first month, 14 subjects were studied for a further 2 mo. Six patients continued bran feeding, and eight, who stopped bran, were used as controls. Patients who took bran maintained metabolic improvement over the 3-mo treatment period, while those who stopped bran did not.

In order to assess the prognostic value of clinical and laboratory variables in liver cirrhosis, 36 of these variables were statistically analyzed in 151 patients followed up for 8 years. The ‘survival time’ was taken as the reference variable. In a first step we analyzed by log-rank test and by Cox’s proportional hazard regression model the data of 98 patients (study group), obtaining 7 prognostically significant variables (age, leukocytes, calcium, potassium, globulins, cholesterol and previous diagnosis). From the regression coefficients of these variables, a risk score was obtained for each patient. To validate the prognostic value of this score, we computed it, using the same coefficients obtained in the study group, in 53 subsequently examined patients (control group) showing that the prognostic score allows the classification of these patients in 3 risk classes with different observed survival times.

— The pattern of utilization of mental health services in south Verona (Italy) and in Groningen (the Netherlands) was studied. The local psychiatric case registers were used to select patients aged 15 years or more who had at least one contact in 1982 and no contacts in the previous 365 days. Each patient was followed for 36 months after the first contact in 1982. The 2 cohorts differed in size (373 in south Verona and 590 in Groningen), age, diagnosis and pattern of care, whereas the sex distribution was similar. The cohort in Groningen was characterized by a higher number of elderly people, suffering from organic psychoses. Drug dependence prevailed in south Verona, while alcohol dependence was predominant in Groningen. The pattern of care was classified according to 2 basic measures, the gross duration of care and the net duration of care. In south Verona single consulters were almost 3 times more common than in Groningen, In general, patients in Groningen tended to depend more on the mental health services. Linear regression analysis was used to determine the extent to which the pattern of care was predicted by the sociode-mographical and clinical characteristics of the patients. Only the site where the contacts were made (south Verona or Groningen) and the diagnosis were significantly associated with the pattern of care.

this study was designed to explore the short-term effect of glipizide on insulin secretion and metabolism. Plasma insulin and C-peptide levels in the fasting state and after a 100-g oral glucose load were measured in 17 obese newly diagnosed type II (non-insulin-dependent) diabetic subjects before and after 1 mo of treatment with glipizide (15 mg/day). Plasma glucose levels decreased significantly after treatment with glipizide. Plasma insulin and C-peptide concentrations in the fasting state did not change after glipizide treatment. Also, postglucose plasma insulin levels did not change after glipizide, whereas postglucose plasma C-peptide concentrations significantly increased. A significant relationship was found between the increase in C-peptide plasma levels and the decrease in glycemic profile after glucose load following glipizide treatment. The relation between plasma C-peptide and insulin incremental areas after the oral glucose load significantly increased after treatment. These results suggest that in obese type II diabetic patients, 1 mo of treatment with glipizide potentiates the (β-cell response to oral glucose load and increases insulin metabolism, probably within the liver.

The presence of tubular involvement, as a marker for the detection of urinary tract infection (UTI) site, was examined in 19 patients with pyelonephritis and in 15 patients with cystitis or asymptomatic bacteriuria. The urinary excretion of four markers of tubular proteinuria, beta 2-microglobulin (beta 2M), lysozyme (LZ), lactic dehydrogenase isoenzyme V (LAD-5) and N-acetyl-beta D-glucosaminidase (NAG), was investigated. LAD-5 appeared particularly valuable for the early detection of upper UTI. However, the overall diagnostic accuracy appeared to be further strengthened using, besides LAD-5, one additional variable. A set of simple and noninvasive biochemical tests on urine samples can reliably help to identify the site of UTI.

A double statistical study of a group of 56 patients affected by idiopathic osteonecrosis of the head of the femur is presented. A comparative investigation was undertaken into this group, taking into consideration the principal biochemical parameters, clinical findings, dietary and living habits. The statistical data that were analysed confirmed the role of some of the aetiological factors concerned. A long-term study was also undertaken, with a preliminary follow-up at 22 months, on the progress of the patients with monolateral idiopathic osteonecrosis of the femoral head who were subjected to a therapeutic programme of dietary correction and the administration of medicaments.

The associations between fat pattern and metabolic profile were evaluated, using cluster analysis, in 214 males and 244 females (aged 21-60 years). The subjects were randomly selected from the patients of one general practice in Castel D'Azzano (Italy). The metabolic status was indexed by blood pressure, blood glucose, uric acid, serum triglycerides, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol (both total and percentage). Fat pattern was evaluated using six skinfolds and three circumferences. The analyses were performed separately on anthropometric and metabolic variables for each sex. The analyses were repeated five times to evaluate the stability of the cluster solution. Anthropometric rather than metabolic variables provided a more stable solution for cluster analysis. Anthropometric clusters showed significantly different metabolic patterns. Most of the differences disappeared when a body mass index (BMI) effect was taken into account but not when an adjustment for waist to hip ratio (WHR) was made. On the other hand, neither BMI nor WHR was able to fully account for the differences in metabolic profiles of metabolic clusters. Cross-classification results of anthropometric and metabolic cluster membership showed a significant, although moderate, degree of association between the two classification sets. These results indicate that in both sexes anthropometric characteristics contribute to a limited degree to the metabolic profile and that the associations probably reflect a complex mechanism.